This long-term project is a primary area within the program plan for analysis of NCPP data. The objectives are to study the epidemiologic characteristics of congenital malformations in singletons and twins; to assess and interpret the influence of maternal, socioeconomic, neonatal, medical and other environmental factors on the occurrence of congenital malformations; to determine the risk of familial occurrence and to elucidate the role of genetic factors and the mode of inheritance of certain malformations; to determine the severity and clinical significance of congenital malformations and their associations with neurological, psychological, and sensory handicaps; and to assess the long-range effects of malformations on survival, growth and development.